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Predictors of Clinical Response and Remission at 1 Year Among a Multicenter Cohort of Patients with Inflammatory Bowel Disease Treated with Vedolizumab

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Abstract

Background

Vedolizumab (VDZ) has demonstrated long-term efficacy in Crohn’s disease (CD) and ulcerative colitis (UC) in phase III trials.

Aims

Our aim was to evaluate the efficacy of VDZ at week 54 in inflammatory bowel disease (IBD) in a multicenter cohort of patients.

Methods

Adult patients completing induction therapy with VDZ were eligible for this study. Clinical response and remission was assessed using the Harvey–Bradshaw Index (HBI) for CD, the Simple Clinical Colitis Activity Index for UC and physician assessment.

Results

Among 136 total patients (96 CD and 40 UC), 76 (56%) demonstrated clinical response or remission at week 54. In univariate analysis, for patients with CD concomitant initiation of immunomodulator therapy (2.71, 95% CI 1.11–6.57), the addition of an immunomodulator (OR 11.49, 3.16–41.75) and CRP < 3 (4.92, 95% CI 1.99–12.15) was associated with increased odds of clinical response or remission at week 54. For UC patients, hospitalization after VDZ induction was associated with decreased odds of response or remission at week 54 (OR 0.22, 95% CI 0.05–0.88). On multivariate analysis in CD, addition of an immunomodulator (OR 8.33, 95% CI 2.15–32.26) remained significant predictors of clinical response or remission at week 54.

Conclusions

Among a multicenter cohort of patients with IBD demonstrating primary response to VDZ, the addition of combination therapy with an immunomodulator is a significant predictor of clinical response or remission at week 54 in patients with CD.

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Author’s contribution

JA and EB were involved in study concept and design, analysis and interpretation of data, critical revision of the manuscript. MS and BS involved in acquisition of data. VY, AA and JK involved in study concept and design, revision of manuscript. All authors approved the final version of this manuscript

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    Authors and Affiliations

    1. Division of Gastroenterology, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02141, USA

      Jessica R. Allegretti, Edward L. Barnes, Margaret Storm & Joshua Korzenik

    2. Gastroenterology Unit, Massachusetts General Hospital, Boston, MA, USA

      Betsey Stevens, Ashwin Ananthakrishnan & Vijay Yajnik

    3. Harvard Medical School, Boston, MA, USA

      Jessica R. Allegretti, Edward L. Barnes, Ashwin Ananthakrishnan, Vijay Yajnik & Joshua Korzenik

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    1. Jessica R. Allegretti
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    2. Edward L. Barnes
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    4. Margaret Storm
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    Correspondence to Jessica R. Allegretti.

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    Conflict of interest

    Ananthakrishnan has served on scientific advisory boards for Abbvie and Cubist. Yajnik has been a consultant for Janssen, UCB, Takeda and Abbvie. Korzenik is supported by funding from Takeda. None of the other authors have conflicts of interest to declare.

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    Jessica R. Allegretti.

    Additional information

    Jessica R. Allegretti and Edward L. Barnes have contributed equally to this work.

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    Allegretti, J.R., Barnes, E.L., Stevens, B. et al. Predictors of Clinical Response and Remission at 1 Year Among a Multicenter Cohort of Patients with Inflammatory Bowel Disease Treated with Vedolizumab. Dig Dis Sci 62, 1590–1596 (2017). https://doi.org/10.1007/s10620-017-4549-3

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    • DOI: https://doi.org/10.1007/s10620-017-4549-3

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